Managing Low Blood Sugar

Everyone who takes insulin for type 1 or type 2 diabetes is at risk for low blood sugar (hypoglycemia). You may also be at risk for low blood sugar if you take certain other diabetes medicines. Learn the symptoms of low blood sugar, how to treat it, and what to do in an emergency.

Living with diabetes means balancing your meal plan, physical activity, and diabetes medicine to keep your blood sugar in the normal range. When these 3 things get out of balance, your blood sugar can get too high — or too low.

In this material, you’ll learn:

∞ What low blood sugar is and when to treat it

∞ How to treat low blood sugar before it becomes an emergency

∞ How to prepare for and treat a low blood sugar emergency

∞ How to help prevent low blood sugar before it starts

∞ Hungry

∞ Sweaty

∞ Nervous

∞ Shaky

∞ Dizzy

Some people who get low blood sugar don’t have any symptoms. That’s why it’s so important to check your blood sugar regularly — and treat it right away when it’s low.

When your blood glucose meter or CGM (continuous glucose monitor) reads below 70 mg/dl (70 milligrams of sugar in each deciliter of blood), you need to treat your low blood sugar.

If you have symptoms of low blood sugar, you may feel:

Whenever you notice these symptoms, check your blood sugar. If it’s below 70, it’s time to treat it.

Low blood sugar can continue to drop very quickly. If your blood sugar drops below 54 mg/dl, you can quickly progress to severe low blood sugar. You could:

∞ Become confused

∞ Have trouble walking and talking

If you check your blood sugar and it’s below 54, stop whatever you’re doing and treat it right away. If it’s not treated in time, severe low blood sugar can make you pass out or have seizures, or even cause death.

Low blood sugar can happen while you’re sleeping. Symptoms may include night sweats, nightmares, or feeling very tired the next day. If you think this is happening, talk to your health care provider.

Low Blood Sugar: When to Treat It

How can I treat my low blood sugar?

If your blood sugar is low (below 70 mg/dl), follow the 15–15 rule:

∞ Eat or drink 15 grams of carbs

∞ Recheck your blood sugar in 15 minutes

If your blood sugar is still low when you recheck it, repeat the steps until it’s back to normal. When your blood sugar is normal again, eat a full meal or snack to keep it stable and prevent another low.

You can use special glucose (sugar) tablets or gels to get your 15 grams of carbs — usually by eating 4 glucose tablets or 1 tube of glucose gel.

Half a cup of fruit juice

Half a cup of full-sugar soda

4 glucose tablets

1 tablespoon of sugar or honey

6 large jelly beans

1 tube of glucose gel

Low Blood Sugar: How to Treat It

Or try carb options like these to get your 15 grams:

When your blood sugar is low, sugary foods and drinks can save your life. Your meal plan may say to cut down on things like juice and soda. But when you have low blood sugar, you need 15 grams of carbs to quickly raise your blood sugar to a safe level — and juice and soda are an easy way to get it.

Tell your health care provider about severe or repeated lows.Talk with your health care provider if you have several blood sugar readings below 70 mg/dl — or if you ever have a reading below 54 mg/dl. They may need to adjust your diabetes medicine, prescribe glucagon, or suggest other ways to prevent severe lows.

Low Blood Sugar: How to Prepare for Emergencies

Severe low blood sugar is a medical emergency. It’s always best to treat yourself by eating or drinking 15 grams of carbs. But if your blood sugar gets really low, you may have trouble eating or drinking — and you may pass out or have a seizure.

What if I can’t eat or drink? If you can’t eat or drink, you need another person to give you glucagon (GLOO-ka-gon). Glucagon is a special emergency medicine that tells your body to release sugar (glucose) into your blood to quickly raise your blood sugar.

Your doctor can prescribe glucagon and show you how it works — but you’ll need help from someone else if your blood sugar is very low.

Take steps to prepare for severe low blood sugar.

∞ Teach your loved ones how to give you glucagon, since you won’t be able to use it yourself in a low blood sugar emergency.

∞ Carry glucagon with you and keep extra glucagon at home and at work. Show loved ones where you keep your glucagon.

∞ Wear a medical alert bracelet so people will know you have diabetes.

Know how to treat severe low blood sugar.

∞ Tell friends, family members, and coworkers to give you glucagon — not insulin — if you can’t swallow the carbs you need, you pass out, or you have a seizure.

∞ Make sure they know to call 911 right after they give you glucagon.

∞ After you get the glucagon and you can swallow again, start taking small sips of juice or full-sugar soda. Then eat a full meal.

How can I prevent low blood sugar?

Insulin and certain other diabetes medicines increase your risk for low blood sugar — but there are lots of things you can do to help prevent it!

Take these steps to lower your risk:

∞ Check your blood sugar regularly and often. Work with your health care provider to find the best way to monitor your blood sugar.

∞ Eat regular meals. If you can’t eat at your regular mealtime, have a snack with carbs and protein in it to keep your blood sugar stable until your next meal. And never skip meals altogether.

∞ Get active safely. Physical activity can lower your blood sugar, so plan your activity after a meal or snack.

∞ Drink alcohol only in moderation. If you choose to drink alcohol, limit yourself to 1 drink (for women) or 2 drinks (for men) — and never drink on an empty stomach.

∞ Be safe when you’re sick. If you throw up or you’re too sick to eat, call your health care provider and ask what you can do to prevent low blood sugar.

If you take mealtime insulin doses, take these additional steps to prevent low blood sugar:

∞ Be exact with carb counts. Your health care provider may teach you how to match your insulin doses to the number of carbs you eat at each meal. Make sure you always read the Nutrition Facts label or use an app to find the exact carb count of each food. If you guess the carbs, you could take too much insulin and cause low blood sugar.

∞ Adjust for physical activity. You may need to eat more carbs or take less insulin when you exercise. Talk with your health care provider if you need help making these changes.

Different people manage their diabetes in different ways. Work with your health care provider to make a low blood sugar prevention plan that’s right for you.

Low Blood Sugar: How to Prevent It

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